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WashingtonSB 58452025-2026 Regular SessionSenate

Modernizing and clarifying timely payment requirements for health carriers.

Sponsored By: Vandana Slatter (Democratic)

Signed by Governor

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Bill Overview

Analyzed Economic Effects

2 provisions identified: 2 benefits, 0 costs, 0 mixed.

Faster insurance payments for health providers

Washington's new payment rules cover qualifying health plans filed or renewed on or after January 1, 2027. They include state-regulated plans and public employee and school employee plans, but exclude Medicaid managed care. They protect contracted providers and facilities, plus Indian health care providers even without a contract. Carriers must pay or deny clean claims as soon as practical, within 30 calendar days of receipt. A clean claim has no missing information or defects that prevent payment. A carrier's own system problems cannot make a claim unclean. For other claims, carriers must send a denial with specific reasons or request needed information within 21 calendar days. They must aim to request everything at once and cannot make additional requests during the first 30 calendar days after receipt. After receiving all requested information, carriers have 30 calendar days to pay or deny, unless both sides agree otherwise in writing. If the provider does not respond within 21 days, that deadline becomes 40 days after the information arrives. Receipt means the carrier receives written or electronic notice of the claim or information. Payment notices must show amounts paid, denied or adjusted, and reason codes. Missed deadlines or notice requirements trigger automatic simple interest on unpaid amounts until payment, denial or appeal resolution. Interest is 1% monthly for days 1–60 of noncompliance and 1.5% monthly afterward. Providers need not file a separate interest claim. Interest cannot count toward patients' deductibles, copays, coinsurance or other financial obligations. The Insurance Commissioner can make rules and consider violation patterns and penalties when claims remain unresolved beyond 90 calendar days. Carriers remain responsible for agents and contractors and cannot shift compliance duties to providers or others. Documented fraud or material misrepresentation supported by reviews or audits excludes claims from these rules. Compliance is excused for acts of God, bankruptcy, government emergency responses, cybersecurity attacks, natural-disaster declarations and labor disputes, including strikes and lockouts.

Shorter insurer refund windows protect providers

Beginning January 1, 2028, Washington health carriers generally have 12 months after payment to request a provider refund, down from 24. When another insurer's payment responsibility is involved, the window falls from 30 months to 18 months. Mental health and substance use disorder services keep their shorter limits: 6 months generally and 9 months when coordinating insurers' payments. Providers cannot be required to pay a contested refund sooner than 6 months after the request. Refunds include both money returned and amounts taken out of future claim payments. These legal protections override conflicting provider contracts unless the provider chooses to refund the carrier. The deadline limits do not apply in specified fraud cases. A carrier can also seek a refund at any time when a legally responsible third party has paid or will pay the provider, preventing recovery from that party. Dental-only carrier services, Medicare services and Medicare supplemental plans are excluded. Carriers retain their right to recover money that subscribers or beneficiaries were not entitled to receive. The Insurance Commissioner can issue rules to carry out the refund requirements.

Sponsors & Cosponsors

Sponsor

  • Vandana Slatter

    Democratic • Senate

Cosponsors

  • Annette Cleveland

    Democratic • Senate

  • Bob Hasegawa

    Democratic • Senate

  • Deborah Krishnadasan

    Democratic • Senate

  • Javier Valdez

    Democratic • Senate

  • Marcus Riccelli

    Democratic • Senate

  • Mike Chapman

    Democratic • Senate

  • Paul Harris

    Republican • Senate

  • Ron Muzzall

    Republican • Senate

  • T'wina Nobles

    Democratic • Senate

Roll Call Votes

All Roll Calls

Yes: 192 • No: 0

Senate vote • 3/9/2026

Final Passage as Amended by the House

Yes: 49 • No: 0

House vote • 3/5/2026

Final Passage as Amended by the House

Yes: 95 • No: 0 • Other: 3

Senate vote • 2/11/2026

3rd Reading & Final Passage

Yes: 48 • No: 0 • Other: 1

Actions Timeline

  1. Effective date 6/11/2026*.

    3/23/2026Senate

  2. Chapter 158, 2026 Laws.

    3/23/2026Senate

  3. Governor signed.

    3/23/2026legislature

  4. Delivered to Governor.

    3/12/2026legislature

  5. Speaker signed.

    3/11/2026legislature

  6. President signed.

    3/10/2026legislature

  7. Passed final passage; yeas, 49; nays, 0; absent, 0; excused, 0.

    3/9/2026Senate

  8. Senate concurred in House amendments.

    3/9/2026House

  9. Rules suspended. Placed on Third Reading.

    3/5/2026Senate

  10. Committee amendment(s) adopted as amended.

    3/5/2026Senate

  11. Third reading, passed; yeas, 95; nays, 0; absent, 0; excused, 3.

    3/5/2026Senate

  12. Rules Committee relieved of further consideration. Placed on second reading.

    3/4/2026Senate

  13. APP - Majority; do pass with amendment(s) by Health Care & Wellness.

    3/2/2026Senate

  14. APP - Executive action taken by committee.

    3/2/2026Senate

  15. Referred to Rules 2 Review.

    3/2/2026Senate

  16. Referred to Appropriations.

    2/25/2026Senate

  17. Minority; without recommendation.

    2/24/2026Senate

  18. HCW - Majority; do pass with amendment(s).

    2/24/2026Senate

  19. HCW - Executive action taken by committee.

    2/24/2026Senate

  20. First reading, referred to Health Care & Wellness.

    2/14/2026Senate

  21. Third reading, passed; yeas, 48; nays, 0; absent, 0; excused, 1.

    2/11/2026Senate

  22. Rules suspended. Placed on Third Reading.

    2/11/2026Senate

  23. Floor amendment(s) adopted.

    2/11/2026Senate

  24. 1st substitute bill substituted.

    2/11/2026Senate

  25. Placed on second reading by Rules Committee.

    2/10/2026Senate

Bill Text

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